The lessons science and pharmacology teach us about
achieving optimal health, vitality and maximal lifespan with a low net carb, high saturated fat, evolutionarily paleolithic-styled diet aligned with my ancestral heritage and how I lost 50 pounds of body fat. A sorta fairy story.

Monday, December 5, 2011

Adrenal Fatigue and Jimmy Moore's LLVLC Podcast

Beautiful PeopleCourtesy Youtube.com

Jimmy's Moore's LLVLC Podcast!

I did Jimmy Moore's podcast! And joined the beautiful people... We initially had some technical (cough cough Chinese (?saturated broadband/censorship)) difficulties which required EIGHT ATTEMPTS, but it's complete. I think Jimmy let out a BIG gentlemanly sigh of relief. Jimmy talked also about his latest and pending labs, the idea for the next epic post on sustainable, local farming/livestock and his thoughts on heavy metal chelation, which I am really REALLY into.

I was/am Jimmy, hormonally. Like Jimmy I have been stubbornly challenged with regaining and relosing 10-20% of my body weight in the last few years after the initial epic loss of 50 lbs (Jimmy, ~180 lbs).(!!!!frustr-WTF-ating!!!!)

My problem was 5-10 lbs yo-yo wt gains and yo-yo losses over the last few years after the initial 50 lb loss, which I attribute to MASSIVE endocrine disruptions (three times). The first hormone dyscrasia involved the Mirena IUD (levonorgestrel, a potent fake/mimicker of progesterone), then followed by adrenal fatigue with the popular intermittent fasting and ketosis, and lastly gut dysbiosis with mercury and metal toxicity (tetanus shot, accumulation of annual flu shots/vaccines, and a drilled on titanium dental implant). What helped me after multiple episodes of adrenal fatigue including one after moving to Shanghai, China was a high carb (150-200 g/day) non-paleo 'adrenal reset' modeled by Diana Schwarzbein MD in her book 'The Schwarzbein Principle II'.

However after getting tired (and frustrated) with the 8-10 lbs of weight gain, I finished the Schwarzbein 'adrenal reset' and easily transitioned to a high carb Kruse 'leptin reset'. I did attempt the Kruse leptin reset with 100g/day (50 g carbs in the morning) but it didn't work the first few times until AFTER I had gained 8-10 lbs on the Schwarzbein 'reset'. I dunno why this was the case. Recently I returned to a stable LC (paleo) + rice + workouts (which worked for my initial 50 lbs fat loss; 50-100 grams carbs/day) and lost a few kilograms in the last month and half.

Adrenal Resets are Leptin Resets IMHO And Vice Versa

The beauty of the Kruse 'reset' is that imho it is also an 'adrenal reset' (and vice versa). Notwithstanding, I believe for many who are adrenally challenged and severely metabolically damaged (like in cases of metal toxicity, environmental toxicity or former vegetarians, yo-yo dieters, over-trainers, under-eaters, etc), the value of an extreme high carb reset (150-200 g/day) with (or without) fat gain may be inconceivable and controversial but UNQUESTIONABLY HIGH if all else fails... Per Schwarzbein, she reports for some extremely metabolically damaged folks two years on the program are mandatory. For me apparently 2 months was ok and sufficient. To safeguard, FYI I still avoid all ketosis, VLC (very low carb) and IF'ing (intermittent fasting). I continue to consume 1/4 to 1/2 tsp Real salt (Utah Redmonds) and maximally play/nap/laugh as much as I can. Adaptogens, liver/GI support, getting morning sunlight, slow BSS/burn, and 'oxygenizing' (employing slow-twitch muscles) without driving excessive cortisol squirts are unbelievably key to staying on track for me. Also my carbs are substantially higher on workout days (100-150 grams wholly based on glycolytic activity and stress) and the weight is still going down without triggering the adrenals.

Heavy Metal Toxicity and Chelation

Jimmy and I talked about chelation and our thoughts; my family and I are still chelating as it requires a minimum of 6-12 months time. I don't endorse many products but this is one I exceptionally fancy because I find it to be safe, gentle, and gradual; the product has been used for over 10 years in physician and practitioners' offices: ExtendedHealth's oral chelator.

• The infectiousness of her e-mail writing style• Her work in a plant biology lab that showed she hated research• The love/hate relationship she has with the USDA• The one-year residency she did working in geriatrics• The certified diabetes education that she pursued• Her hesitancy to start blogging with so many great bloggers• Her contributions to the PaleoHacks.com web site• The “chronic cardio” she believes is right for her• The slow rate of weight loss she experienced (50 pounds in 5 years)• How Keith Norris has a “Zen-like charm” about him• What her experience was like at the Ancestral Health Symposium• The important message of Dr. Andreas Eenfeldt in Sweden• How Aaron Blaisdell and Brent Pottenger are changing the world• Recollections of past interviews with Gary Taubes• The positive contributions Taubes has made to the low-carb cause• How the Dietary Guidelines are making Americans sicker• The autoimmune issues she and her siblings dealt with growing up• How even some grass-fed beef can taste a little “off”• The “scary” nature of finding real food in China• Whether America would have been successful without carbs• Her take on the “safe starches” debate that’s happening right now• The great admiration she has for Dr. Robert Su• How there are plenty of Asians who get “sick” eating white rice• How she “completely burned out my adrenals” on intermittent fasting• Why some people have issues that make it more difficult to get healthy• The high-carb adrenal resets that need to have for many people• Why you have to have balance with all of your hormones• Her weight gain from heavy metal toxicity• What the future of her “Animal Pharm” concept is• The book she is writing with her sister on gut health with recipes• Why she wants to open up a gluten-free cafe to teach cooking• Her desire for us to outsource the Low-Carb Cruise to China

Your description of eating 100 g of carbs on work out days sounds like his notion of carb cycling to improve hormone health. He eats a carb heavy dinner every 3rd or 4th day (alternating between the two to keep it random) and then right back to paleo style eating. His book is very informative. Have you read it.

Thanks for this. I've been fighting with adrenal fatigue for about a year and a half now and just never seem to know what advice to follow, especially after being pretty much told I was crazy by my endo (who was a real dick about it). :-)

I completely did myself in with VLC dieting combined with intermittent fasting. I have screwed up my system so much it's just next to impossible to lose weight, sleeping has become very difficult (after 40-some odd years of never having had problems) and I have anxiety attacks. I really think that IF is a bad idea for a lot of people.

You know I greatly miss and *heart* you???! Can you find my email at 'view complete profile' and send me a love note???

I do everything already for the last 2-3 yrs that you recommend *wink*. Seriously. Actually I'm lame I don't take as much C as I could... (only 2 g twice daily) I've read the same things as YOU. Until I got the chelator on board, very few things improved. It is funny but I think I chelate the best route via sweating and low-mod intensity, high volume exercise... Bikram yoga (105 F) however nearly killed me and my adrenals!

Thanks for the NAC link. I've been taking pycnogenol + grapeseed extract for years. This is an amazing combo as it helped my niece (along with paleo) to overcome 95% of the mild autism she was suffering.

I don't know how to check glucagon? How? I know it is WONKY as I get weird BGs unless I am working out, sleeping well, minimizing caffeine (cortisol) and not stressed (deep breathing, deep yoga, deep f*cking HAA AHAA).

Thank you for kind thoughts!

Fred T,

I initially took the 12.5mg every other day for 1-2 mos then took one every week (or switched back and forth from Iosol liquid).

The skin route is wonderful! I wear black a lot so I wouldn't have to worry about the staining. I do feel concern about hurting the good gut flora with such a large non-food related source by mouth (orally).

Temporarily until things metabolically fix up, using Armour 1/2 to 1 grain has helped tremendously. Because of the low adrenal function I couldn't initially tolerate and practically LICKED THE TABLET. The titration was so slow and gradual.

Olga,

Thank you for your comment. I love Faigin but haven't read his book, only the online chapter (free). He's great. I have been carb cycling between 20-40 and 40-80 g/day however the amount was too low for what I was doing and when I did the IF'ing and some days VLC, the adrenals completely bonked out. I am not too 'aware' of my body though now I certainly am more sensitive and tuned in to changes (sweating, heart rate, fatigue, calm, happiness).

Like you, I've had great metabolic success with the Kruse reset and perhaps because of the high carb 'reset', my metabolism kicked in by 2weeks. The carb cravings with Schwarzbein were UNBELIEVABLE. Yet, within about 1-2 days of the Kruse leptin Rx, they were gone and I felt noticeably happy and slept better again.

I tried to do the 'random' thing and it doesn't make sense to my body. It likes structure apparently *haa ahaa!* I like to sleep 8-10 hrs nighly also -- I think this is why I survived 2 pregnancies (non-paleo). Girls have different metabolisms than boys. I don't have the same musculature/sarcophilia and just cannot do the same 'prescriptions' that work for most of the male bloggers and writers out there. I think for the most part (and particularly after SAD, birth control damage) we gain fat much more easily with environmental toxins (mercury, flame retardants, pesticides, plastics, BPA, etc), n-6 pufa seed oils, excessive carb-nutrition, omega-3 deficiency, and sleep/sun/circadian disruptions on an epic scale.

Also once fat, the pattern to oversecrete estrogens from the adipose is there I believe epigenetically...

My DHEA-S is actually fine when I checked it several years ago and probably ok now.

Many integrative practitioners employ 'precursors' to raise other hormones (E3, testosterone, etc) and DHEA deficiency...like over the counter DHEA. My thoughts are that lab testing and/or is necessary. Our biochem pathways are 'black boxes' and testing is necessary to see where the pathways are leading and not overproducing harmful metabolites which can lead to detriment (male pattern baldness, cystic breasts, or worse testicular, prostate or mammary cancer). Supporting the hormone pathways (see the links I provided in the resources) requires adequate zinc, selenium, iodine, activated B vitamins, cobalamin, folinic acid/MTHF, omega-3s, phytonutrients, vitamin DAEK2, gut, and liver support. Please let me later what works for you and which resources were most helpful. Have you considered Schwarzbein and the Kruse leptin rx?

There are so many dimensions to adrenal fatigue (it really is a whole lifestyle ailment...food, exercise, mental state, work) I'm finding it hard to wrap my mind around it sometimes.

Thanks so much for the comments here and on PH. There is just so much (conflicting, often) information out there about what to do. I wasn't familiar with the Kruse program. I have to admit that I'm a little scared to go too low-carb, as I fear that's perhaps what got me in this mess in the first place. Maybe it was the VLC and the IF'ing combined. Really just want to get my DHEA up a bit before I do anything too crazy.

Hey, lady, thanks for the mention! Great post (and I love your blog in general;) Adrenal fatigue is such a beeyotch.

My doc gave me an herbal combo that has really helped:I'm on a tsp. of a liquid combo of rehmannia/ashwaganda/Korean ginseng taken twice daily between 6-8 am and 11am-1pm to get my morning and midday cortisol up.If anyone wants to recreate the formula for their own use, it's 96 ml/67 ml/37 ml of liquid extracts combined in the order I listed them in. It rocks.Between that and the low dose pregnenolone, my progesterone was good for the first time in, like, forever!

If I need it, I use Apex Adrenacalm phosphatidyl serine cream (you can get a way bigger dose that way). I can tell my adrenals got a little whacked again due to a nasty adenovirus and the PS cream helps calm down the weird cortisol surges I had started to get at night and at 6 am.

Note about the leptin reset giant breakfast: it makes my brain work so much better. Love!!

I wanted to mention one more thing. HMD is an awesome chelator that was extensively double blind placebo controlled tested in a long-term study in Russia. It also detoxes xenobiotics. You might want to check it out:http://www.heavymetaldetox.net/Heavy%20Metal%20Detox/What%20is%20it.htm

Grace I enjoyed hearing you on Jimmy podcast immensely. I will say to you that the core of the Leptin Rx reset does play to adrenal rewiring. In fact I have a blog in que for you about cortisol and how it ties directly into the circadian cycle of leptin and cortisol that I am going to dedicate to you. I hope to see you soon! Stay in touch from China!

Like many who have had 'BIG FAT LOSS', I appear to require a certain volume of movement that is 'fat burning'. Fat oxidation by the mitochondria needs oxygen, hence this is aerobic. When I say aerobic, it sounds totally old school, like so 80's or Jane Fonda! Some athletes are EXCEPTIONALLY conditioned and I believe have trained the mitochondria to be efficient fat burning powerplants even at higher outputs and mild hypoxia/anaerobic-thresholds...

I don't run everyday because I'm into Fuhrman and his 3-day per week plan. My max mileage is 15-20 miles in a week.

This is not entirely accurate as we're all different with different # and quality of mitochondria but take 220 and substract your age. This the max of HR (heart rate). Efficient aerobic fatburning occurs at approximately 50-70% of this. Cut the max in half -- that is a good target to stay within for 60-90 min most days. For me, my HR is like 100-120 beats per minute typically and it's truly almost meditative and relaxing (esp with good music -- I can do this 'sweet spot' working out nearly forever).

Hillwalking, city-hiking, vigorous housework, cycling, swimming, jogging hit this pretty easily... I jog -- not fast run. For a half marathon I do like ~~70-75% of max HR. Several devices on the market have heart monitors you may strap on and will give you precise analysis of your workout (as well as GPS/google map data inputes) and will track even ascent, temperatures, mileage, bike reps and even foot steps... COOL if you are into that.

Sprints have value but for those REALLY REALLY fat (like I was and now) training the slow twitch endurance muscles to work efficiently by engaging in oxidative exercise daily or most days is the key to adequate health. IMHO optimal health relies on other things -- exercise recovery, hormone signatures, mental health, community supports, etc. There is also great value in Body by science (Dr. Doug McGuff and John Little) weight lifting -- this burns the visceral (waist) fat off without triggering cortisol as some Crossfit WODs and sprints might... Takes but only 10-20min per week (fast twitch muscle training; WHITE MEAT).

There is also remarkable value in 'muscle confusion' and crosstraining -- I love hip hop/clubbing, kick boxing, tai chi (just started-- HOLYCOW IT IS SO HARD), flow yoga, swimming, cycling, rowing, etc... need to mix it up for the BRAIN.

My story sounds a lot like YOUR STORY. Yes -- the Crossfit combined with IF'ing and VLC (and for me mini tri's and half marathons) was bad for my adrenals which were marginal at best earlier. Additionally I failed to supplement salt and other electrolytes well. The years of doing of training and doing half marathons depleted the minerals. Literally my baseball caps (all 3) were coated with mineral/salt deposits from sweat. Sorry! TMI. The cyclists know this -- they replete minerals well.

The panic attacks could be triggered by hypoglycemia and the subsequent counter-regulatory adrenaline dumping (adrenaline induces gluconeogenesis to raise glucose for muscles in flight/fright/fight mode). Try a protein + carb snack (2-3 times per day) and see if that helps? This is the same nutritional info for Type 1 diabetics on insulin who are 'brittle' with frequent hypoglycemia, and also for Type 2 diabetics with autonomic dysregulation (HPA-gut axis problems) and freq dangerous hypoglycemia.

Good luck -- the first 2 resources I listed maybe helpful for you. You are not that tough to biohack -- you need more testing if you have not evaluated and assessed the progesterone. This is often overlooked in men -- this supports cortisol and is CALMING. You mentioned licorice. I can't take it because I have a 'high adrenaline state' however those with VERY LOW adrenaline states do pretty well with licorice. Licorice pumps up the adrenaline aspect in a gentle fashion... (for some it raises BP excessively and that OTOH is NOT GOOD). I actually at one point tried at diff times DHEA and preg. I didn't tolerate at the time because my progesterone was ROCK BOTTOM (as indicated by short 24-26 day menstrual cycles). Check out your progesterone.

There are creams for both (for easy absorption bypassing the gut; easy to titrate to LOW ultra low dosing):http://www.iherb.com/Now-Foods-Solutions-Natural-Progesterone-Liposomal-Skin-Cream-Scent-Free-3-oz-85-g/779http://www.iherb.com/Life-Flo-Health-DHEA-Plus-Highly-Absorbent-Body-Cream-2-oz-57-g/14140

Hey GIRLFRIEND!!! I love how you do qigong and neuro feedback!! Now that I'm in China I have some more access to TCM and tai chi...

The HMD product looks good -- did you or clients try out yet? Klinghardt and his trainees are really into the chorella and growth factor -- I have not tried yet but appears very effective to me.

I love adaptogens -- esp the Russian ones -- but I'll ck out the Herb Pharm's Rehmannia. THANK YOU FOR YOUR RECIPE!!!

Have read a lot but not tried the Apex Adrenacalm phosphatidyl serine cream. It's an awesome cream. I do love Kharrazian and his products and advise them, esp the neuro and neurotransmitter ones... I'm using DFH phosphatidyl choline by the handfuls but I have to admit they are the first things I skip... (coz I eat like 4-6 egg yolks most days).

Thanks for such a detailed response! Had to laugh at your Tai Chi is hard as hell comment since it certainly can be! I used to work at a Tai Chi school and one of the memorable comments of the eldest prof was: I´ve had many yoga students try Tai Chi... they can´t get that coordination thing down.. Had to prove him wrong as gently as possible.yes, mixing it all up is so good for the brain. if you get bored you can mix up hulahooping, kinomichi and Yamuna bodyrolling. It´s all good.

I love adaptogens, too! Rhodiola and I are BFF's. Rehmannia is a special kidney/adrenal loving herb (in Chinese, the name means "kidney's own food"- it's in all the major TCM restorative tonics). Chyavanprash also rocks.

OMG, qigong was/is the life changer of life changers for me! It helped my adrenals when nothing else could (and it turned me into a Daoist, lol!). If you find Tai Chi too challenging, qigong requires less coordination, but has the same benefits (and maybe more, as it's more focused on organ/emotion balancing).TCM is my hobby. My acupuncturist (from Shanghai) LOVES it when I tell her about my black chicken herbal soup, heehee. I do tongue diagnosis every morning when I get up (it's such a useful thing!) Where in China are you living?

I've used the HMD and my old retail customers used it and everyone all around seemed to tolerate it really well and get good results.

I just recently got out of doing neurofeedback, but I give it a huge thumbs-up. I'll probably post on it soon, just to get the word out to people, since it's still kind of obscure. I think so many people would benefit.

Had to go back and look at my ASI results from September. Progesterone looks good, actually. My free cortisol rhythm was on the low side of normal except for the noon reading (a little too low), which is a huge improvement over the one I had a year ago which was just a flat line across the bottom. Eek.

OK NOW WE'RE MAKING PROGRESS. You are like Jimmy and I. Your hypothalamus and pituitary are sensing the high E (estrogens) and low T (testosterone) and boosting FSH to round these imbalances out.

(a) You might have metals...(b) You also might have xenoestrogens...(c) Excessive stressors (but who doesn't???!) have you stopped crossfit???! have you started yoga and relaxation at night to bring down PM cortisol???? Massage? Sex/ecstasy? More oxy-T? Hug therapy???

Read:ori hofmekler, author of the 'warrior diet' and columnist at (both) Penthouse and Playboy (no I don't subscribe just in case ur wondering), 'The Anti-Estrogenic Diet'

This book is awesome -- I take DIM and many of the other supplements, foods, diet he advises. Once we have cortisol-driven adipose (visceral and white adipose, WAT) which overly secrete estrogens (esp E1 and E2, not the anti-inflammatory E3 estriol), we experience a complete imbalance and relative estrogen dominance. For men, this makes them grrrrrrls. For girls, this makes us b*tchy, bad and brash. Also fat, fatigued and FUZZY.

It's all reversible. You need to focus on the liver (where you probably also have FATTY, calcified liver, NASH or NALFD), omega-3 deficiency and excessive inflammation. The only thing that I don't agree with Hofmekler on are:

(1) ketosis -- he advises alternating VLC days with high carb days; this is a cardinal no-no when one has flat-lined cortisol/ASI or recovering from a flat-lined adrenal hormone signatures

Do you read energy fields? Personally I ck out SKIN. This tells me the gut...

With the chelation i've had to alternate (with topical DMPS) because it does affect the gut since it's all oral but after the recent carb reset, it appears to work better. Hard to reset the 'gut' and liver with $*%&# wonky adrenals...

Will need a must-do guide from your acupuncterist. Any English classes in Shanghai, which is where we are for this year and possible next (may go to Germany next year).

I don't touch much chinese herbs due to metal and other contamination problems. Also I have problems if not harvested from known sustainable sources... major prob here.

Something about chyavanprash makes me feel really good. It does have sugar/honey in it (and usually ghee to help absorption) but Himalaya makes some in caps, too. I honestly don't mind the sugars because it also has herbs that normalize blood sugar, so I figure it all works out.

A great source for CLEAN/sustainable Chinese herbs is Dragon Herbs. Ron Teeguarden is the man when it comes to tonic herb formulations and their herbalists on staff do free herbal consults when you call their 800 #. Their goji berries are the best, bar none. I love their Lights Out formula- not for sleep, but for daytime stress. It's like magical happy pills for me! Seriously, it makes me feel happy for no reason (that's always welcome;-) I wish I could go wild with tonic formulations, but too many have astragalus and it's contraindicated for my Hashimoto's (I used to take it and it kept me from getting colds, but I think it also kept my immune system hyperactive!)

I did training in reading/palpating energy fields and I can do it to a degree, but I need to practice way more. Everything is energy field reading in medical qigong. I can tell if an organ has deficiency or excess going on but I have a hard time feeling all the different fields (sea of ying qi, sea of blood, sea of marrow, etc.) I'm better at executing qi emission than diagnosis, lol.

Hi Dr. BG,How often do you do a carb load of 150-200 g/day and at what time of the day? Dr. Kruse says it should be at breakfast, and Rob Fagin says it should be the last meal of the day. Kruse says AM because cortisol is at it's highest, and Fagin says PM because he wants the greatest time elapsed from spiking your insulin until you eat again in the morning. Who's right??? Any insights?

In past and currently I do a load of 100-150 g a few days prior and on big workout days or race days (sprint tri, half marathons) with anything -- rice, chocolate, icecream, etc. I don't really like yams but I think these and red/heirloom potatoes are great and have lower GI (glycemic index) than some of the cr*p I sometimes eat... Have to admit, I am a food-fiend and often I workout just so I can eat.. with criminal negligence. Sorry this is the truth. If I didn't work out, the weight/fat gain creeps within 1-2 wks in noticeable ways. I've been this way since my high schools years!

Honestly I think both Kruse and Faigin are correct but it depends uniquely on the person... Does that make sense? Some have high cortisol in the morning (like me) and it behooves metabolism to get the serum insulin high (or at least relatively higher) compared with cortisol in the morning. The adrenals like this; read Schwarzbein.

Faigin may be dealing with healthier, less toxic and more mitochondrially competent and adrenally competent individuals. An insulin spike at night won't drastically inhibit GH (growth hormone) and subsequent leptin, testosterone and other hormone casecades for these healthier folks... Typically however insulin spikes WILL cock-block testosterone and GH, thus prevently maximal muscle gains if you read the literature. Art DeVany and other 'muscle' focused are LC and avoid carbs and high fat at night for this reason... it is true but for those adrenally safe and fine, the insulin spike DOES grow muscles (but for those not so inclined fat + muscles).

PRETTY ERIN!! ;)

I'd like to hook up with you when I visit TN...!!!! We'd have a lot of fun. I'm gonna check out all the refs and links -- THANKXXXX I could've used the 'happy pills' when I first arrived here in Shanghai! Fortunately I found some crossfitters, exercise nuts, cool galpals and things are much better but life transitions sure kicked my ass there. Oh massages helped too esp the ones from the guys that studied some qigong -- I don't know what they instilled in their touch but BOY it does work (no placebo effects).

Thanks for the information. I have one more question about Kruse vs. Faigin. What do you think about their advice with regards to meal frequency. Kruse wants us to aim for two meals per day. Breakfast and then dinner. Where as Faigin recommends eating about every 4 hours (at least 4 meals per day). They both are trying to focus on hormonal resets/enhancement which is why I am comparing these two specifically. If I try to follow Dr. Kruse' plan, and skip lunch,I get light headed and jittery. Faigin, is trying to keep cravings at bay, and Kruse is trying to eat at the times of day when cortisol is highest. Do you have any insights to one verses the other? Really enjoying the chat.

You and Denise should make a book, it could cover so many spaces AND bring rational paleo-style omnivorism to gals too! Take Melissa McEwen in as well!

I see there is some NAC stuff going. What do you think of my beta-alanine boosting combo (on top of paleo eating): NAC, alpha-lipoic acid % tocotrienols I got rid of 23 pounds last summer? I see BA-induced carnosine chelates mercury and such but is there any base for possible fat loss too? Got some muscle too, even though I'm just a runner type mostly.

Lastly, my friend tried pycnogenol for seasonal allergy with no avail. Are there other hot/steamy suggestions around?

Hello Dr. G...how are you??? I haven't checked in in a while, for school began again in September and my second grade class has been keeping me BUSY. But I'm here now and, as always, am soaking-up as much as I can of the great info you provide:)

This post on adrenals caught my eye, of course, considering my adrenal issues. I recently commented on Dr. Andro's blog SuppVersity, giving him a brief rundown of my problems because I was interested in his take on the body's use of protein for glucose when it's not getting enough. Here is some of what I told him:

I have a very hard time maintaining muscle and generally 'leaning out'. Some background on me:- currently 31 year-old female at 133 lbs., 5'5"- initially lost inches, then gained about 20 lbs of 'chub' when I went low-carb/higher fat paleo - and lots of cellulite in my legs! (was up to 141 lbs., but dropped some when I added some carb back into the mix)- have a history of disordered eating...bulimia, calorie restriction- have tried every route I can imagine to get lean - zone diet, paleo, fasting, low carb/high fat, high carb/protein and low fat, etc., etc.- workout every other day with kettlebells (typical workout might be - 3 pistols @ 18lbs, 5 pushups, 2 get-ups @ 12 kg, 10 snatches/arm @ 12 kgs., rest 90 seconds and repeat 3 times, plus additional swings at 16 kgs.)- currently eat about 100 g protein/day, 150 carbs, 50 fat split between 5 meals/day, yet feel hungry constantly- I cannot seem to maintain muscle and my body (especially my legs) are mushy and my stomach is constantly bloated (it was more so, but I began using psyllium husk at night. This helps some, but it is still generally bloated and puffy)- drink about 100 oz. filtered water/day and 1 cup of coffee in the am- I do sleep in a dark room, approx 7 hours/night- a Paloquin trainer tested me and declared me 'carb tolerant'- I believe I have some adrenal fatigue problems, but have never been diagnosed. When fasting and low carb, I was very moody, spacey-headed, lacked focus. Now I also take 5-htp, phosphatydiserine to reduce cortisol at night (for sleep) and l-tyrosine and acetyl l-carnitine in the a.m. to wake me up

His response was insightful, but he said, "with your current meal plan, I venture the guess that you NEVER feel satisfied, correct? I also think that the way you are trying to fix your "adrenal problem" works against you, as you need MORE not less cortisol". He recommended a possible DiPasquale Anabolic Diet, too, which I wasn't sure about for me because I do seem to become irritable, lose muscle tone, and have patchy sleep patterns when low-carbing. The part about needing more cortisol confused me, as it's counter intuitive to everything I have learned.

I'm also somewhat confused in regards to the differences in leptin/adrenal resets (Kruse low-carb vs. Schwarzbein high-carb)...I just don't know which direction to go in. I have been eating higher carb, as of late, and feeling better in regard to mood, sleep, etc. But am still having trouble leaning-out and maintaining muscle, and I've been sick (sinus infections and now an ear infection...and am on antibiotic, much to my dismay) three times already since September. Maybe the high intensity workouts are too much for every-other-day? I recently went to the doc for a yearly exam and she did order bloodwork, though recommended I wait until the second day of menstruation to see if my body is producing an egg (due to my PCOS). What are your thoughts? Should I wait or just get it now to check my thyroid, cortisol, etc.?

Anyway, any insight you have will be greatly appreciated. I hope you are well:)

loved your podcast with jimmy!! :) if u are interested in making your glutenfree cafe international we would LOVE to jump on board - maybe we could facetime some episodes to raise awareness - got a kitchen in our box here in Nuernberg

When the body crashes with IF, exercise or ketosis, that signals there are underlying metabolic issues specifically mistiming of cortisol and adrenaline (adrenals).

Marisa,

Ditto! Schwarzbein didn't seem that specific except that fatburning would take place again. I think it is when the normal 'fluxes' of the hormones/transmitters resume. Insulni -- spikes timed with meals with good tissue insulin sensitivity. Cortisol -- spikes timed with appropriately with stress (am >> pm) and good sensitivity. Adrenaline -- ditto.

Johnny Boy,

Not exactly 'hot/steamy' but boosting the immunity helps most seasonal allergies. The products may work if nothing else works. Pycnogenol works for some perhaps but not everyone probably because of immune differences.

The key is to focus on the highest hormone dysregulation... No. Don't low carb. This burns out adrenals and doesn't help if you have mild insulin resistance (versus pre-diabetes and T2DM). Personally 'low carb' is a wide definition because technically anything < 200 grams daily according to most convention is 'low carb'. The SAD is like 350-400 grams carb daily. For you finding the sweet spot will depend on low-intensity exercise and what causes fat/weight gain. TOUGH!!!

Must read: http://www.drlam.com/articles/adrenal_fatigue.asp

The above is one of the best adrenal resources I've found and it's updated, modern and merges Western with Eastern thoughts. Lam is an MD MPH.

For adrenals (this is why you have experienced frequent infections):--no intensity--absolutely no super intensity until things are stable--the more CALM, the faster the healing--invest in the art of doing NOTHING ;)

Since you have problems gaining lean mass (and fat burning), it appears to me the body is good at sugar burning and sacrificing the meat and muscles to burn protein (amino acids) in preference over fat. This is because the adrenals are not synced with the brain/thyroid/gonads.

Are you addrenssing--Magnesium deficiency -- everyone is deficient this leads to insulin resistance which is the hierarchical problem in PCOS--Zinc deficiency -- remember we once talked about the 'zinc tally' test with David? This takes MONTHS to alleviate -- need zinc as this is needed for gonads and making the right sex hormones, among a zillion other things--Digestion support? Do you need Betain HCl? Enzymes?

You are on great stuff for adrenal -- PS, carnitine, tyrosine, 5HTP -- but are you taking an adaptogens????? Mega vitamin C? Yoga? Meditaion? Quiet times? Naps?

While she has ordered some additional bloodwork to check for AM cortisol (my initial app. was in the afternoon) and anti muliarial hormone (whatever that is), she red-flagged on the low estradiol and thinks I might be looking at early menopause. What are your thoughts on this? Do you think bulimia and/or adrenal fatigue could be to blame?

I do take zinc chelate (30-60 mg/day), as well as digestive enzymes (though not HCL) and vit C (but only 2 g/day...how much is too much?). I cut out the magnesium because I would take it at night and wake up soooo foggy the next day. Possibly I should reintro it - was taking Natural Calm...any other recommendations?

Do you think I should see a naturopath for infertility? I have been wanting to, in general, but I literally live in the middle of nowhere and have to drive 2+ hours to find anyone reputable (and who has time for that!?!). There are just SO MANY factors to consider - it truly is overwhelming!

We put on fat for a reason and some of the science is good. Poliquin is good for guys but I feel he misses it for grrrrrls, from what I have seen (which is obviously limited as I have not been certified yet). Turner (The Hormone Diet) points out that fat spots on thighs signify low GH for both men and women. I also would add that estrogen dominance contributes, which also degrades GH.

The P lab value you posted needs some context (relative to possible ovulation).

Here are some normal ranges for the above:http://www.flash-med.com/LabNormal.asp

Have you ever been worked up for CAH or non-classical CAH? It occurs in about 1/10th of PCOS cases especially in certain ethnic backgrounds. Has your practitioner evaluated the possibility of metals in the soft tissues yet?? Metals cause digestive stress and adrena/thyroid disorders. http://www.drdach.com/PCOS.html

The labs tell a lot with your fat testing. [You can do more extensive tseting to verify like rT3, thyroid antibodies, the salivary cortisol x4 as you mentioned and a stim test as discussed for ruling out non-classical CAH.]

My thoughts for you to consider:(a) incompetent adrenals/thryoid -- which came first this or bulimia. I think they're intimately related. It's like the chicken-n-the-egg...

Goals: perfect ASI, lower third of range rT3, upper third FT4, upper third FT3 [TSH is useless]; no thyroid anti-bodies

(b) Estrogen dominance: super low progesterone and the presence of xenoestrogens and/or endogenously made estrogens (E1, estrone) and/or inflammatory estrogen metabolites which was not tested. This would be helpful to know. Have you lived in a new home? exposed to solvents? Plastics?

(c) Insulin resistance and low GH. Per Natasha Turner ND, to solve need SLEEP SLEEP SLEEP, exercise, consume sufficient protein and manage STRESS STRESS STRESS. I would add that the intense stuff (if you're still doing) is not ideal right now. For insulin resistance low-moderate intensity exercise for EXTENDED LENGTH like 45 to 90min (only if one can do without fatigue afterwardds) is best to improve insulin sensitivity in peripheral tissues. Zinc?? Howz the zinc and zinc tally? That can take 3-6 months for repletion, don't give up! Methylated B vitamins and methyl-folate? Are you a hypomethylator? Are you on a full spectrum of activated, methylated B vitamins, P5P, pantothenic acid, etc? These help GH production whilst utilizing amino acids from food (arginine, glutamine, ornithine, leucine, BCAAs, tyrosine, etc). GH occurs in pulses and fluxes during the day but is massively released during sleep, napping and when we engage in acetyl-choline inducing activites (calm, resting and after meals) without stress.

Good luck... it's hard to find practitioners that are aligned without tons of pharmaceuticals including bioHRT but I think some good ones exist. ck this out...http://www.suzannesomers.com/sexy-forever/SEXY-FOREVER-online-resource-guide.pdf

You are TOO AWESOME for taking the time to give me such an in-depth response. I am currently seeing and endo who is doing boatloads of tests. She has actually ruled out a diagnosis of PCOS basically because I have NO OTHER SYMPTOMS of this aside from irregular periods and cysts on the ovaries (she tells me that some women simply have cysts). She is leaning toward premature menopause, however she is continuing to test, test, test. She also mentioned that it might have taken the hypothalamus some time to regulate itself after years of calorie restricting/disordered eating, though she is leaning toward premature menopause (which would ultimately lead me to a fertility specialist). I am being hopeful, as my last 3 cycles have come right around the same time each month...

I wonder though, do you think it's possible that my having taken DIM might have decreased my estradiol levels? This seems to be what is red-flagging premature menopause...

I'm sorry for my radio/net silence... my VPN goes down and I'm a moron on getting it resurrected (or now my kids are hogging the VPN-computer)!

Have you read the books on my R-side bar like Dr. Uzzi Reiss MD?

The Natural Superwoman: The Scientifically Backed Program by Uzzi Reiss MD

I'm re-reading right now as I have met a sea of infertile women here in Shanghai. Dr. Reiss notes that in his decades of experience, he has been seeing YOUNGER AND YOUNGER patients with severe premature meno conditions. He doesn't understand why. (also he's not yet a proponent of gluten-free or paleo, as far as I can tell, but funny he does advocate dairy-free for infertility/PMS)

However, he is strictly adamant against all chemical hormones especially low-dose birth control and ANY birth control and other chemical hormones like Provera and Depo. He is absolutely correct. These chemicals may actually be partly behind the epidemic of infertility and hormonal dyscrasias seen in women and men. Since we excrete many of these compounds via the kidneys and urine, they maybe finding their way to municipal water and our drinking water and those of livestock. Anyway since the problem is multifactorial, the solutions need to be as well.

YES. DIM may lower estrogen. This is a problem is estrogen is already low. Dr. Reiss uses bioidentical E3 (estriol) and E2 (estradiol) frequently in treating infertility where estrogen is low (and it frequently is).

In the 'progesterone' chapter he reviews the many reasons why progesterone may not be enough or may even exacerate the problem. This was new to me!! Makes entire SENSE but he lists them well and succinctly 'opposite-from-expected effects' p. 120:

(b) increased agitation -- result of higher than preferred cortisol levels. Happens because P blocks an enzyme 11bOH-steroid [hydroxylase] which is meant to convert cortisol to cortisone, the inactive form of cortisol. Cortisol can be agitating. normally Progesterone has a calming and even sedating effect sometimes.

(c) water retention-- occurs when the rise of cortisol overcomes the diuretic effect of progesterone. Again an excessive cortisol downstream effect.

actually I was further reading and Uzzi Reiss is no-grains/low-grains. He's a little too LC (low carb) for me if someone is indeed in adrenal dysfunction, but otherwise the dietary and nutritional advice are good.

Hi. I began to have daily adrenal crashes a month ago, getting worse each day, that scared the shit out of me. I sorta knew eating carbs would help, but I've been soooo indoctrinated. I am a "LOW CARB believer since atkins came out. I'm 49. so i ate some hydrocortisone, instead of trying carbs. that is screwed up man. after two days on hc which should be ok at 20 mg, i was like. eat a sandwich. i drank gingerale, and it helped. then i found this post and it blew my mind. 150-200 g ch2o. wow. i am not sure how to proceed. if i eat carbs i'm going to weigh 400 pounds. i dunno if you would hack my labs or talk to me if I wrote my "persistent hypothyroid symptoms return, even though labs were decent on 2.25 grains. worked hard to get from 185 down to 145, took years. very low carb seemed to be the key to losing. but i would get suicidal. then i read jack kruse and was trying leptin reset. wsn't losing weight. got tested for iodine, i'm low, and i have bromine toxicity. found out i'm low ferritin, low B12, E2:p=47, hashi's antibodies are high even though i'm no grain no starch no a1 dairy no eggs no nightshades no sugar no chemicals in the house...i read about clearing reverse t3 and also did a circadian t3 only method attempt, that resulted in immediate adrenal crashing. wtf? never been so scared..." story. bless you and the photos of the kittens made me bawl (ya i've been losing it 3 times a day, tears.)i'm 5'4 and 167.5

i just began to read about methylation and its like AHA. no fucking wonder. i am a bag of 49 years of toxins. no wonder i got so sick.

but if i open detox with adrenals so tanked i'll get dead. is eating carbs truly the thing to do now? for two months? I've gone from 145-167.5 since i got return of these bad hypothyroid stumptoms in march. i have nothing to wear. if i exercise at all, i collapse from weakness, head right into what feels like pulmonary shock and like i'm going to die. its obscene.

fuck man. i went on hydrocortisone 20 mg for a year ten years ago and i ended up with a buffalo hump on the back of my neck, moon face, no waist,strech marks, and i never really recovered. i weaned on the hc, but i still had weak adrenals. did you get tested for 23 and me and do that protocol? is that why you take chelation supps? regards and bless you. Ruth in thunder bay ontario.